This document provides an overview of the clinical interview process. It discusses the characteristics of a clinical interview, including that it is a one-on-one conversation between a professional and client in a professional setting. It describes the different types and structures of interviews, such as intake interviews, case history interviews, mental status exams, crisis interviews, and diagnostic interviews. Communication strategies for building rapport and conducting the interview are also covered, along with considerations for different populations and common pitfalls.

1. CLINICAL INTERVIEW
BY
MUHAMMAD MUSAWAR ALI
MPHIL, ICAP
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2. Clinical Interview
Characteristics of
Interview
Communication
Strategies
Types and Structure of
Interview
Roles and Tactics
Considerations and Issues
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3. INTRODUCTION
 The clinical assessment examines a client’s life in far more
detail so that accurate diagnosis, appropriate treatment plan,
problem lists and treatment goals can be made.
 Identifies client’s strengths, weaknesses, along with
appropriate level of treatment and care.
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4. Characteristics of Clinical Interview
 One to one conversation between a
professional (psychologist) and
client
 Professional setting (hospital,
clinic)
 Conversation either initiated by
client or by psychologist initiated
 Purposeful and goal oriented
conversation
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5. Types and Structure of Clinical Interview
1- Intake Interview
 Why the client is looking for
help?
 Are the competencies and
resources available to help
client ?
 Build rapport
 Make the client at ease
 Encourage for information
 Think rules
 Behavior (actions)
 Solution (handling)
 Positive (resources)
 Small steps (increments)
 Flexible (possibilities)
 Future (control)
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6. Types and Structure of Clinical Interview
2- Case History
 Psychosocial history
 Detailed description of client's
background
 Birth and development
 Family origins
 Education
 Employment
 Recreational/leisure
 Marital and Sexual history
 Alcohol and drugs
 Physical health
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7. Types and Structure of Clinical Interview
3- Mental Status Exam
 Protocol for organizing
observations of client
 Switch to direct questioning at the
end of interview
 General appearance and
behavior
 Speech and thought
 Consciousness
 Perception
 Obsessions and compulsions
 Orientation
 Memory
 Attention and concentration
 General Information
 Intelligence
 Insight and judgment
 Higher cognitive functioning
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8. Types and Structure of Clinical Interview
4- Crisis Interview
 Emergency consultation
 Unexpected life stressors
 can’t be assessed through
lengthy psychological
batteries
 can’t be waited to access
previous history
 Client needed to be dealt at
moment
 Provide reassurance, assess
the problem and explore
potential resources
 Resolve problem
immediately to avoid
catastrophic event to occur
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9. Types and Structure of Clinical Interview
5- Diagnostic Interview
 Goal is to classify the complaints
and dysfunctions of client
 Clinician observers:
 client’s behavior
 Inquires about symptoms in
detail
 Gathers relevant personal
and family history
 The methods for conducting
diagnostic interview vary in
goals and degree of structure
 Five steps in diagnostic
interview ( Othmer & Othmer,
1994)
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10. Process of Diagnostic
Interview
1- Diagnostic clues
• Helps in creating a list possible,
unexplored and excluded
disorders
• “tell me what’s troubling you”
2- Specific diagnostic criteria
• Specified questions related to
specific criteria
• “have you ever been bothered
by voices or seen things that
nobody else could hear or see ?”
3- Psychiatric history
• Has the client received mental
health services
• Premorbid functioning & family
history
4- Arrive at a Diagnosis
5- Prognosis
 Based upon the gathered
information, the clinician
estimates the likely future
course of disorder and client
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11. Methods for conducting Diagnostic
Interview
Un-structured
 Most probably used
 To develop
diagnostic
formulation
 Reliability issues
Structured
 Predetermined
questions
 Set of rules to probe,
sequence inquiries
and rating the
responses
Semi-Structured
 Somewhat unstructured
and predetermined
 Improves rapport
building
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12. Importance of Rapport
 The sense of mutual trust and
harmony that characterizes a
good relationship (Giordano,
1997)
 Warmth and empathy
 Genuineness
 Immediacy
 Positive regard and respect
 Self-disclosure
 Consent taking
 Confidentiality assurance
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13. Communication Strategies
 Verbal strategies
 Reflective listening
 Asking open-ended questions
 Affirming
 Summarizing
 Rolling with resistance
 Non-verbal strategies
 Facial expressions
 Eye contact
 Body posture
 SOLER (micro-skills)
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14. Roles and Tactics
 Strategies for Rolling with
resistance
 Reflective listening
 Shifting focus
 Ignore client’s negative
statement
 Agreement with a twist
 Agree with client but with a
change of direction
 Reframing
 Offering a new and positive
interpretation of negative
information
 Emphasizing personal choice and
control
 Acknowledge the positive
choices a client makes and
improve his self-efficacy
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15. Other considerations and
issues
1- Interviewing with children
• Praise
• Ask simple questions
• Be tactful
• Understand silence
2- Cultural diversity issues
• Need to avoid the biases and
influence of experiences
• Educate about communication
styles of culture where you
work
• Understand local
communication norms
3- Common pitfalls
• Jargon pitfall
• Reassurance pitfall
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16. Motivational Interviewing
Express empathy
&
Support self-efficacy
Roll with
resistance
Avoid argumentationDevelop
discrepancy
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17. Motivational Interviewing
 Express empathy and support self-efficacy
Stay non-judgmental and help the client towards changing themselves
 Develop discrepancy
Focus their attention towards the discrepancy in their goals and actions
 Avoid argumentation
Rather confronting with client, show a gentle persuasive style
 Roll with resistance
Move with the resistance by challenging their thoughts
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